ORCHARD PARK, N.Y. (AP) - Bills rookie quarterback EJ Manuel is closing the season much like he opened it, facing questions about yet another knee injury.

''Tell me about it,'' Manuel said Wednesday after being ruled out from playing against Miami this weekend because of a swollen left knee. ''When it happened in the game, I just said to myself: `Is this really happening again?' ''

Manuel is out after being hurt in a 27-20 win at Jacksonville on Sunday. That leaves journeyman backup Thad Lewis to make his fourth start of the season and second against the AFC East rival Dolphins.

Coach Doug Marrone said Manuel will miss the game Sunday, but should be healthy enough to play in the season finale against New England the following weekend.

It's the third time Manuel has been sidelined since training camp because of knee issues. The injury is to the same left knee that forced the first-round draft pick to miss the final two preseason games. He also missed four regular-season games because of a sprained right knee.

''It's adversity, and that's all you can really say about it,'' said Manuel, who missed only one start over his final two years at Florida State due to injury. ''You obviously don't want to get the tag of being injury prone or, the worst word, `soft.' And I know I'm not, but you still have to be smart with your body. You want to have a nice, long career.''

The Bills (5-9) have been eliminated from playoff contention. The Dolphins (8-6), meanwhile, control their own playoff chances. Miami, which has won three straight and four of five, can clinch a berth by winning Sunday and having both Baltimore and Cincinnati lose.

Marrone made the decision to sit Manuel early into practice after the quarterback showed difficulty with his mobility inside the field house. Manuel was then sidelined once Marrone shifted the session outside on the slick turf at Ralph Wilson Stadium.

Marrone said Manuel's lack of mobility and instability in the knee would have made it difficult to play. He was also concerned how ready Manuel might be with limited practice time.

The injury is the latest setback in Manuel's spotty development. He was drafted with the 16th pick, the only quarterback taken in the first round.

Manuel has gone 4-6 as a starter and was finally showing signs of progress after winning his first road game. The game against Miami was to be a chance for Manuel to help Buffalo string together consecutive wins for the first time since Weeks 2 and 3 of 2012.

The Bills will also likely be without top receiver Stevie Johnson, who has been excused to be with his family in California following the unexpected death of the player's mother on Saturday.

''I don't believe that he will be available for our game on Sunday,'' Marrone said. ''And I think it's important we realize this tragedy, and our thoughts and prayers are with Stevie and his family.''

Marrone also considered starting safety Aaron Williams' chances of playing Sunday as ''50-50.'' Williams did not practice after hurting his ribs while making a tackle in the fourth quarter against Jacksonville.

Lewis has been a capable backup since being promoted from the practice squad on Oct. 7. He went 1-2 in place of Manuel before Lewis was sidelined by a rib injury in a 35-17 loss at New Orleans.

Lewis is from Miami, and his victory came against the Dolphins on Oct. 20, when he went 21 of 32 for 202 yards and an interception in the 23-21 win.

''Having the opportunity then was great, and being able to take advantage of that opportunity was even better,'' Lewis said. ''Then having another opportunity to help this ballclub get another win against a division opponent is great. So that's what I'm focusing on right now.''

The Bills acquired Lewis in a trade with Detroit in August, after Manuel hurt his left knee. He was cut by Buffalo before the start of the season and then signed to the team's practice squad.

Overall, the Duke product has gone 62 of 103 for 652 yards with three touchdowns and two interceptions.

Cleveland Browns RB Terrance West worked with the first-team offense during team drills Thursday, July 30. Head coach Mike Pettine said several running backs will see time with the starters during training camp.

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